Provider Demographics
NPI:1992108559
Name:DAY, LISA (CMT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4876
Mailing Address - Country:US
Mailing Address - Phone:307-673-4649
Mailing Address - Fax:
Practice Address - Street 1:303 S MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-4876
Practice Address - Country:US
Practice Address - Phone:307-673-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider